{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T08:35:24Z","timestamp":1794040524706,"version":"4.8.0"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2021,11,16]],"date-time":"2021-11-16T00:00:00Z","timestamp":1637020800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,6,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Paediatric onset IBD [PIBD] is characterised by a more extensive phenotype than adult-onset IBD and a higher utilisation of immunosuppressive medications; both may be associated with malignancy. We aimed to assess the risk of cancer in a nationwide cohort of PIBD and to explore the risks associated with medical treatments.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>PIBD patients [&amp;lt;18 years old] were included from the epi-IIRN cohort, covering 98% of the Israeli population from 2005, linked to the national cancer registry. We matched PIBD children to non-IBD children for calculating the cumulative incidence of cancer.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In all, 3944 PIBD cases were included (2642 [67%] Crohn\u2019s disease, 1302 [33%] ulcerative colitis) translating into 23 635 person-years of follow-up, individually matched to 13 005 non-IBD children. By 30 years of age, 14 IBD patients [0.35%, 5.9\/10 000 patient-years] were diagnosed with cancer and one [0.03%] with haemophagocytic-lymphohistiocytosis [HLH], compared with 14 [0.11%, 1.9\/10 000 patient-years] cases of cancer {relative risk (RR) 2.5 (95% confidence interval [CI] 1.05-6.2); p = 0.04} and no HLH in the comparison-group. There were no cases of hepatosplenic T cell lymphoma, adenocarcinoma, or cholangiocarcinoma. Cancer risk was 15.6 cases\/10 000 person-years in those treated with thiopurines alone (RR compared with IBD patients never exposed to either thiopurines or anti-tumuor necrosis factor [TNF] 1.8 [95% CI 0.6-6.1]; p = 0.2), 11.1\/10 000 in those treated with anti-TNF alone (RR 1.3 [95% CI 0.3-6.6]; p = 0.5), and 23.1\/10 000 treated with combination therapy of anti-TNF and thiopurines (RR 2.8 [95% CI 0.6-13.8]; p = 0.2).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>PIBD confers an increased risk for malignancy compared with non-IBD in children. However, the absolute risk is very low and no differences in risk with specific therapies were apparent in our data.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ecco-jcc\/jjab205","type":"journal-article","created":{"date-parts":[[2021,11,11]],"date-time":"2021-11-11T20:13:55Z","timestamp":1636661635000},"page":"786-795","source":"Crossref","is-referenced-by-count":23,"title":["Risk of Cancer in Paediatric onset Inflammatory Bowel Diseases: A Nation-wide Study From the epi-IIRN"],"prefix":"10.1093","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7800-1984","authenticated-orcid":false,"given":"Ohad","family":"Atia","sequence":"first","affiliation":[{"name":"Juliet Keidan Institute of Pediatric Gastroenterology Hepatology and Nutrition, Shaare Zedek Medical Center, Hebrew University of Jerusalem , Jerusalem , Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sasha","family":"Harel","sequence":"additional","affiliation":[{"name":"Juliet Keidan Institute of Pediatric Gastroenterology Hepatology and Nutrition, Shaare Zedek Medical Center, Hebrew University of Jerusalem , Jerusalem , Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natan","family":"Ledderman","sequence":"additional","affiliation":[{"name":"Meuhedet Health Services, Research Institute , Tel Aviv , Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shira","family":"Greenfeld","sequence":"additional","affiliation":[{"name":"Maccabi Health Services, Research institute , Tel Aviv , Israel"},{"name":"Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Revital","family":"Kariv","sequence":"additional","affiliation":[{"name":"Maccabi Health Services, Research institute , Tel Aviv , Israel"},{"name":"Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iris","family":"Dotan","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Rabin Medical Center , Petah Tikva , Israel"},{"name":"Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ran","family":"Balicer","sequence":"additional","affiliation":[{"name":"Clalit Research Institute, Clalit Health Services , Tel Aviv , Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Silverman","sequence":"additional","affiliation":[{"name":"Israel Center for Disease Control , Tel Hashomer, Ramat Gan , Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eran","family":"Matz","sequence":"additional","affiliation":[{"name":"Leumit Health Services, Research institute , Tel Aviv , Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zohar","family":"Levi","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Rabin Medical Center , Petah Tikva , Israel"},{"name":"Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matti","family":"Waterman","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Rambam Healthcare Campus , Haifa , Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iris","family":"Fried","sequence":"additional","affiliation":[{"name":"Pediatric Hematology Oncology, Shaare Zedek Medical Center, Jerusalem , Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob M","family":"Rowe","sequence":"additional","affiliation":[{"name":"Department of Hematology, Shaare Zedek Medical Center, Jerusalem, Israel, and the Technion, Israel Institute of Technology , Haifa , Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Turner","sequence":"additional","affiliation":[{"name":"Juliet Keidan Institute of Pediatric Gastroenterology Hepatology and Nutrition, Shaare Zedek Medical Center, Hebrew University of Jerusalem , Jerusalem , Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,11,16]]},"reference":[{"key":"2022062411305447800_CIT0001","doi-asserted-by":"crossref","first-page":"1784","DOI":"10.1093\/ibd\/izaa341","article-title":"Epidemiology of inflammatory bowel diseases in Israel: a nationwide Epi-Israeli IBD research nucleus study","volume":"27","author":"Stulman","year":"2021","journal-title":"Inflamm Bowel Dis"},{"key":"2022062411305447800_CIT0002","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1111\/j.1365-2036.2004.01858.x","article-title":"Intestinal and extra-intestinal cancer in Crohn\u2019s disease: follow-up of a 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